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Pulmonary Hypertension

(Also known as: Pulmonary arterial hypertension or PAH)

The Progression of Pulmonary Hypertension in the Arteries of the Lungs
(Click to enlarge)

Pulmonary hypertension is high blood pressure in the arteries in the lungs. The arteries are narrowed which makes it more difficult for blood to flow through. Pulmonary hypertension puts a lot of strain on the right side of the heart causing symptoms such as irregular heartbeat, shortness of breath, dizziness, or heart failure. Pulmonary hypertension is treated with medications and lifestyle changes and, in some cases, surgery.

About Pulmonary Hypertension

The heart is a muscle that pumps blood around the body through a series of tubes called arteries. The left side of the heart receives fresh, oxygen-rich blood from the lungs and then pumps it out to all parts of the body. The right side of the heart gets the blood back from the body and pumps it to the lungs where it picks up more oxygen and the cycle begins again.

Pulmonary hypertension is high blood pressure that occurs in the blood vessels in the lungs. They become narrowed and stiff making it difficult for blood to flow through.

The pressure can be high on the right side – in the blood vessels that bring blood from the heart into the lungs to get more oxygen, or high on the left side – the blood vessels that bring oxygen-rich blood from the lungs back to the heart.

Pulmonary hypertension decreases the amount of blood flow into the lungs. This decrease causes the right ventricle in the heart to pump harder to try to get more blood to the lungs. The right side of the heart (right ventricle) can become enlarged from this extra effort which may lead to heart failure.

Causes

Many different medical conditions can cause pulmonary hypertension such as:

Treating pulmonary hypertension often requires a variety of approaches. Usually people with pulmonary hypertension are sent to specialists who can make the best recommendations for care depending on the specific patient.

Medications

Commonly used treatments for pulmonary hypertension include medications that dilate (open) the blood vessels so the heart can pump easier. These medications work to:

Many different types and classes of medications are available for reducing the symptoms of pulmonary hypertension. Not all medications will work for all patients; it depends on the underlying cause. A patient may need to try several different medications before finding one that works for them.

Oxygen Therapy

Some patients with pulmonary hypertension may need to breathe pure oxygen through an oxygen mask or though tubes that fit into the nose. Breathing pure oxygen can help relieve shortness of breath and can reduce blood pressure in the pulmonary arteries.

Surgery

Some causes of pulmonary hypertension can be treated with surgery. If a blood clot in the lungs causing pulmonary hypertension does not dissolve on its own, a type of surgery called pulmonary thromboendarterectomy may be used to remove the clot(s).

Sometimes, a patient with severe pulmonary hypertension who no longer feels better with medications and is short of breath at rest may receive a lung transplant or a heart-lung transplant. These procedures can be performed only in patients who are healthy enough to undergo major surgery.

Lifestyle Changes

Although patients with pulmonary hypertension may find exercising difficult, some patients find that light exercise helps relieve their symptoms. Patients considering beginning an exercise program should consult with their doctors before changing their level of physical activity.

Quitting smoking can help with lung function in general and can specifically help relieve symptoms of pulmonary hypertension. Smoking-cessation aids are available to patients who find it difficult to quit on their own.